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APHA Scientific Session and Event Listing

Recorded presentation

Eric A. Swedberg, MPH, Office of Health, Save the Children Federation Inc., 54 Wilton Rd., Westport, CT 06880, 203 221-4011, eswedber@savechildren.org

Background: Save the Children Federation implemented a three year Child Survival project in Nacala-a-Velha and Memba Districts in northern Mozambique in 2000 to 2003. The districts had an estimated population of 286,814 with a U5MR of 315/1000. Community Leadership Councils generally have 10 members (nurses, traditional birth attendants, traditional healers, activistas, other community leaders). Methods: A population-based Knowledge, Coverage, and Practices survey was conducted at baseline and endline. An external evaluation assessed (1) if the program had met stated objectives; (2) effectiveness of the technical approaches; (3) lessons learned. Results were also analyzed using the 2003 Lancet child survival methodology, which estimates mortality reductions from project outcome data. Results: CLCs were created in the 46 regulados to: (1) educate community members through talks, theatre, and songs; (2) maintain Alarm and Transport systems with bicycle ambulances; and (3) serve as the link between health facilities and the population. The community volunteers trained during the project are now part of these new community structures working together to decrease child mortality. The project achieved objectives in immunization, and child spacing, maternal and newborn care, malaria control: (1) Raised full immunization rate from 32 to 55%; (2) Raised knowledge of >2 family planning methods from 24 to 50%; (3) Raised birth attendance by trained personnel from 34 to 50%; and (4) Raised care seeking with 48 hours for fever from 66 to 80%. Recommendations: Community leadership teams should be replicated as a high impact, low cost, and sustainable approach to promote behavior change and empower communities.

Learning Objectives:

• By the end of my presentation, the participants will be able to describe the unique community-based structures called “Community Leadership Councils” which were a critical part of the MCH program success in northern Mozambique, and describe health outcomes achieveable with this structure.

Keywords: Community Participation, Community-Based Health Care

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation